Thrombolytics, Anticoagulants, and anti-platelet drugs Flashcards
ADP analogs (ADP receptor antagonists)
irreversible
use in pts that don’t tolerate ASA
Clopidogrel
Ticlopidine
Prasugrel
GP IIb/IIIa inhibitors
Abciximab
Eptifibatide
Tirofiban
Thromboxane inhibitor
aspirin
acetylsalicylate
Adverse effect:
Thrombocytic Thrombocytopenic Purpura
ticlopidine
ADP analog, activated by CYP2C19
Clopidogrel
Humanized MAB against GP IIb/IIIa
Abciximab
Fibrinogen analog
Eptifibatide
non-peptide competitive inhibitor of GP IIb/IIIa receptor
Tirofiban
Inhibit final common pathway for platelet aggregation
- angioplasty
- acute coronary syndromes
GP IIb/IIIa receptor inhibitors
**given IV
Phophodiesterase 3 inhibitor
increases cAMP
vasodilator
needs to by given with ASA or warfarin
Dipyridamole
Indirect Thrombin Inhibitors
Unfractionated Heparin
LMW Heparin (Lovenox)
Fondaparinux (a pentasaccharide)
Direct Thrombin Inhibitors
Bivalirudin
Argatroban
Dabigatran (oral)
Binds to ATIII
knocks out Thrombin AND Xa
HMW heparin
binds ATIII, more effect on Xa
LMW heparin
Only inhibits Xa with ATIII
100% bioavailability
Fondaparinux
Antidote to HMW heparin OD…
Protamine
Block synthesis of vit K dependent clotting factors
warfarin
Direct factor Xa inhibitors
Rivaroxaban (xarelto)
Apixaban
Edoxaban
**no antidote
**don’t require monitoring
Vit K dependent factors:
II VII IX X protein C
More active enantiomer of warfarin:
S
metabolism of S enantiomer of warfarin:
CYP2C9
Three tPAs:
altePLASE
retePLASE
tenectePLASE
How do tPAs localized?
Preferentially activate plasminogen that is bound to fibrin
Potent inhibitor of fibrinolysis
Aminocaproic acid
